The Mirena intrauterine device (IUD) is a contraceptive that works by releasing synthetic hormones into the uterus over time. Possible side effects of these IUDs may include vaginal bleeding changes.

You may have heard of the Mirena intrauterine device (IUD) but wonder whether it works effectively during menopause.

We are here for you. This article aims to provide some guidance on whether Mirena IUDs mask menopause symptoms and how it may make this natural life stage a bit easier for some people.

First approved by regulators in 2000, Mirena partially suppresses ovulation — the release of an egg from its follicle — to stop you from getting pregnant. Stands to reason that releasing fewer eggs will make the ones you have last longer and make you go into menopause later, right? Wrong.

Even if you do not ovulate, you steadily lose follicles as you age. Mirena, or any other type of contraceptive, doesn’t seem to affect the time it takes to get to menopause.

Mirena can improve at least one menopause symptom — heavy bleeding.

In the years leading up to menopause (perimenopause), your estrogen and progesterone levels bounce up and down. These shifting hormone levels can make your periods lighter or heavier than usual.

Almost one-third of people may experience heavy periods. Your monthly flow may get so heavy that you soak through a pad or tampon every couple of hours.

The Mirena IUD may lighten your periods and help you experience a more normal flow pattern.

Hormonal IUDs like Mirena can make periods lighter. Some people with IUDs stop getting a period altogether. If your periods do stop, it can be hard to tell whether you’re in menopause.

Mirena can also cause a few symptoms that look a lot like menopause, including shifts in mood and irregular periods.

But an IUD shouldn’t affect other menopause symptoms. It only releases progesterone, not estrogen. As your estrogen level naturally drops, you can still expect to have menopause symptoms like hot flashes, trouble sleeping, and flushed skin.

There is some research that suggests progesterone alone might help some people with perimenopause symptoms, such as hot flashes and night sweats, as well as with sleep quality.

But that doesn’t appear to affect IUD guidance and how it may work for people in menopause.

Want to know more about menopause symptoms?

Learn more about the various symptoms of menopause and your options for treating them.

A few other symptoms can pop up that make you wonder whether you’re going through menopause — or second puberty.

These symptoms can be due to the hormone progesterone in Mirena:

  • tender breasts
  • headache
  • cramps or pelvic pain

You usually don’t need tests to diagnose menopause. When your period stops for a full 12 months, you’re typically in this life stage.

But since the IUD stops your periods, you need a backup plan. Your doctor can do a blood test to check levels of follicle-stimulating hormone (FSH) and estrogen. FSH helps regulate your menstrual cycle and egg production.

During menopause, FSH levels rise, while estrogen levels drop. A healthcare professional can order a blood test to look for these level changes.

Your FSH levels can rise and fall throughout your cycle, so your doctor might need to take a couple of blood tests over time. They’ll also look for symptoms like hot flashes to determine whether you’re in menopause.

Mirena can lighten your monthly bleeding, but it doesn’t relieve other menopause symptoms. For that, you might turn to hormone therapy (HT), formerly known as hormone replacement therapy (HRT).

HT pills, patches, and injections help with menopause symptoms like:

HT comes in two forms:

  • estrogen-only therapy for those who’ve had a hysterectomy
  • estrogen plus progesterone for those who have a uterus

HT has been linked to an increased risk of stroke, blood clots, breast cancer, and more. That’s why you may take the lowest effective dose for the shortest length of time needed to relieve your symptoms.

Your doctor can help you decide whether HT is your best option.

You may also need to know that if you’re not fully in menopause, you can still get pregnant while on HT.

Even though fertility naturally declines in your 40s, you can still get pregnant until you’re in menopause. To avoid an unplanned pregnancy, leave your IUD in until you’re past the average age for menopause — around 51 years.

If you still get periods, wait for at least 1 year after they stop to remove the IUD. Or switch to another birth control method, such as condoms or the pill.

If you’re not sure whether the IUD has made your periods stop, talk with a healthcare professional. They can confirm with a blood test whether you’re in menopause.

It’s fine to leave your IUD in until it expires if you’re not sure whether you’re in menopause.

Those who are 50 to 55 years old and may begin experiencing menopause may discuss IUD removal with their healthcare team to determine whether that remains what they need. This is the long-standing guidance from the ACOG.

The United Kingdom’s National Health Service (NHS) reports that copper IUDs last for up to 10 years.

Mirena and other progesterone-based IUDs should come out after 8 years, according to Planned Parenthood. If Mirena is prescribed to treat heavy periods, the manufacturer advises removal after 5 years.

Although the feeling is similar, removal is typically easier than insertion.

Here’s what to expect:

  1. You lie back on the table with your feet in the stirrups.
  2. Your doctor uses a speculum to slowly open your vaginal canal.
  3. After locating the IUD, your doctor gently pulls on the string.
  4. The arms of the IUD fold up, and the device slips out through your vagina.
  5. If the IUD doesn’t come out on the first try, your doctor then uses an instrument to remove it.

You might feel some cramping for a minute or so after the IUD is removed.

An IUD can lighten or even stop your periods, making it hard to tell whether you’re in menopause. Check with your doctor if you’ve reached your 50s and you still aren’t sure whether you’ve moved into menopause.

Consult your doctor if you experience symptoms that are unusual for you, including missed or heavy periods, vaginal dryness, pelvic pain, depression, and mood swings.

Be aware that periods that don’t end at the typical time or are irregular may not be a cause for concern — everyone goes through menopause uniquely.